The effect of an enhanced recovery protocol in pediatric patients who undergo colostomy closure and Malone procedures.
Pediatr Surg Int
; 38(12): 1701-1707, 2022 Dec.
Article
in En
| MEDLINE
| ID: mdl-36098796
ABSTRACT
PURPOSE:
Pediatric colorectal studies have shown enhanced recovery after surgery (ERAS) protocols can safely improve outcomes. This study sought to determine the impact of an ERAS pathway on the outcomes of children with colorectal conditions who underwent colostomy closure or Malone procedure.METHODS:
A single-institution, retrospective cohort study of children who underwent colostomy closure or Malone procedure between 2016 and 2020 was performed. Differences in outcomes between pre-ERAS and ERAS cohorts were tested. A sub-analysis based on procedure type was performed.RESULTS:
There were 96 patients included 22 prior to ERAS implementation and 74 after. Patients who underwent ERAS had shorter mean time (hours) to oral intake, mean days until regular diet, post-operative opioid volume, and median length of stay (p < 0.05). There was no difference in complication rates in the ERAS and pre-ERAS cohort (12.2 vs 9.1%, p = 0.99). Patients who underwent colostomy closure after ERAS had lower post-operative opioid use, but no differences were seen in those who underwent Malone.CONCLUSION:
Implementation of an ERAS protocol resulted in quicker time to oral intake, normal diet, and decreased opioid use without increasing complication rates. Differences seen based on procedure type may reflect that the effect of an ERAS protocol is procedure specific.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Analgesics, Opioid
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2022
Document type:
Article
Affiliation country: